CurrentMom: Health Care Reform and Information Technology

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Technology Thursday

After decades and decades and several failed attempts, the U.S. Congress has finally made a small amount of progress towards health insurance reform and, to some extent, health care reform. Notwithstanding the screeching overblown fear-mongering hysteria in some quarters, the legislation that passed is actually very incremental and legislates several common sense and humane requirements (such as not refusing health insurance to children with pre-existing conditions -- there are stories of even newborns being deemed by their parent's insurance company to have been born with pre-existing conditions.) There was a nice chart at the Chicago Tribune that lays out basically what the law does. I consider this, no surprise, to be a bare minimum and think that much more needs to be done before the United States can consider itself a civilized society when it comes to healthcare and its citizenry. For parents, two immediately good things were extended the length of time that children can stay on their parents' health insurance policy and, of course, mandating that insurance companies not exclude children with pre-existing conditions.

Another interesting angle in health care reform as to do with mandates and incentives regarding the use of information technology in healthcare. The buzz I'm hearing is that healthcare IT is likely to be a huge issue in coming years, in terms of business opportunity but also potentially in terms of impact on patient care. But, as usual, the details and implementation will determine how effective future changes and innovations will be. I've heard some be very enthusiastic about future possibilities, but I've also heard some lament that while intentions may be good, there is insufficient fresh thinking to really make good progress. In any event, there are many ways that health care reform and information technology will intersect in the months and years ahead.

There was a chunk of the stimulus bill, for example, that was aimed at expanding health IT and the new healthcare reform bill also emphasizes electronic medical records and payment systems. In my family we see a range of doctors and also see a corresponding range of approaches to records management. My primary care practitioner uses electronic files, at least to the extent that she carries a laptop into each appointment and has copies (scans I think) of information sent over from specialists. She even prints off her prescriptions, so that it is completely clear what and in what doses one is being prescribed. But my son's pediatricans' office, modern in many ways, still carries around paper files and if we show up just 2-3 days after we've already been there, they might not be able to find his chart because it hasn't been re-filed yet. Not to mention that I cringe as they all try to read each other's handwriting from the last visit. And I certainly can't read their handwriting on the prescriptions (with a couple of exceptions). So I look forward to increased use of electronic medical records but I'm still trying to keep at least a rough record myself because it will be years and years, I suspect, before we have anything nationwide that is comprehensive, up-to-date, accurate, and secure.